目的 探讨青春期甲状腺功能亢进症(甲亢)对生长发育及精神状态的影响。方法 选择2017-01至2018-12武警辽宁总队医院就诊的青春期甲亢患者50例作为观察组,同期随机选择至该院体检的同年龄段青少年50例作为对照组。所有人员均测定身高、体重、甲状腺功能、血清Ca2+、P2+、ALP,进行PSQI、SAS、SDS问卷调查。比较两组的相关指标,并分析FT3、FT4、TSH水平与其他指标的相关性。结果 观察组身高<-2 SD、体重<-2 SD、BMI<18.5(kg/m2)所占比例显著高于对照组,差异有统计学意义(P<0.05)。两组受试者的血清Ca2+、P2+水平无统计学差异,但观察组ALP水平、PSQI评分、SAS评分、SDS评分均高于对照组,观察组中PSQI≥16分、SAS≥50分、SDS≥53分所占比例亦显著高于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析发现FT4水平与PSQI评分、SAS评分、SDS评分呈正相关(P<0.05)。结论 青春期甲亢影响青少年的生长发育和精神状态。
Abstract
Objective To analyze the influence of adolescent hyperthyroidism on the growth and mental status of adolescents.Methods Fifty patients with adolescent hyperthyroidism treated in our hospital between January 2017 and December 2018 were selected as the observation group, while another 50 adolescents of the same age were randomly selected as the control group. Height, weight, thyroid function, serum Ca2+, P2+, ALP were measured, and PSQI, SAS and SDS questionnaires were used. The related indexes were compared between the two groups, and the correlation between FT3, FT4, TSH and other indexes was analyzed.Results The proportions of height<-2 SD, weight<-2 SD and BMI<18.5(kg/m2) in the observation group were significantly higher than those in the control group (P<0.05). There were no significant difference in serum Ca2+ or P2+ levels between the two groups, but the ALP level in the observation group was significantly higher than that in the control group (P<0.05). The scores of PSQI, SAS and SDS in the observation group were higher than those of the control group. The proportion of PSQI≥16, SAS≥50, SDS≥53 in the observation group was also significantly higher than that in the control group (P<0.05). Pearson correlation analysis showed that the FT4 level was positively correlated with the scores of PSQI, SAS and SDS (P<0.05).Conclusions Adolescent hyperthyroidism can affect the growth, development and mental state of adolescents. Importance should be attached to the prevention and treatment of adolescent hyperthyroidism.
关键词
青春期 /
甲状腺功能亢进症 /
生长发育 /
睡眠障碍 /
焦虑 /
抑郁
Key words
adolescence /
hyperthyroidism /
growth /
sleep disorder /
anxiety /
depression
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Léger J, Carel J C. Diagnosis and management of hyperthyroidism from prenatal life to adolescence[J]. Best Pract Res Clin Endocrinol Metab,2018,32(4):373-386.
[2] 姜泽雯,郑孝东.甲状腺功能亢进症皮肤改变误诊为结节性红斑1例[J].武警医学,2019,30(9):797-798.
[3] Cramon P,Winther K H,Watt T,et al. Quality-of-life impairments persist six months after treatment of graves’ hyperthyroidism and toxic nodular goiter: a prospective cohort study[J].Thyroid,2016,26 (8):1010-1018.
[4] Conaglen H M,Tamatea J A,Conaglen J V,et al. Treatment choice, satisfaction and quality of life in patients with graves' disease[J]. Clin Endocrinol (Oxf),2018,88(6):977-984.
[5] 支朦朦,袁勇贵,李 玲. 甲状腺功能与情绪及认知障碍关联的研究进展[J].东南大学学报(医学版),2016,35(4):612-616.
[6] 张 霄, 杜怡峰.甲状腺功能亢进症的神经系统并发症[J].临床神经病学杂志,2016,29(4):313-315.
[7] Hanley P,Lord K,Bauer A J.Thyroid disorders in children and adolescents: a review[J]. JAMA Pediatr, 2016,170(10):1008-1019.
[8] Simon M, Rigou A, Moal J L, et al. Epidemiology of childhood hyperthyroidism in france: a nationwide population-based study[J]. J Clin Endocrinol Metab, 2018,103(8): 2980-2987.
[9] Gill D S,Greening J E,Howlett T A,et al. Long-term outcome of hyperthyroidism diagnosed in childhood and adolescence: a single-centre experience[J]. J Pediatr Endocrinol Metab, 2019,32(2):151-157.
[10] 廖坷华,李 妮,卢桂南.青春期甲状腺功能亢进患者骨龄及骨代谢的特点分析[J].实用医学杂志,2013, 29(6):928-930.
[11] 陈 瑶,王 静.青春期甲亢患者骨代谢特点分析[J].中国伤残医学,2014,22(7):115-116.
[12] 任爱芬.甲状腺亢进患者睡眠障碍的原因及护理探讨[J].中国医药指南,2018,16(7):211-212.
[13] Medici M,Direk N,Visser W E,et al.Thyroid function within the normal range and the risk of depression: a popula-tion-based cohort study[J]. J Clin Endocrinol Metab,2014,99(4):1213-1219.
[14] Ittermann T, Henry V, Baumeister S E, et al. Diagnosed thyroid disorders are associated with depression and anxiety[J]. Soc Psychiatry Psychiatr Epidemiol,2015,50 (9):1417-1425.
[15] Li L, Zhi M M, Hou Z H,et al.Abnormal brain functional connectivity leads to impaired mood and cognition in hyperthyroidism: a resting-state functional mri study[J]. Oncotarget,2017,8(4):6283-6294.
[16] Tunç S, Köprülü Ö, Ortaç H, et al.Long-term monitoring of graves’ disease in children and adolescents: a single-center experience[J]. Turk J Med Sci, 2019,49 (2):464-471.
PDF(804 KB)
